Weekly Update from The Bellingen Covid-19 Clinic: Dr Trevor Cheney

Dr Trevor Cheney gives his weekly report from the Bellingen Shire Covid-19 Clinic

Dear Bellingen Shire

26 January 2021

 

Yep no cases, no “spikey” crowned poo in our sewerage, and the state is looking pretty good.

The rest of the world…. Sometimes I feel like the grief is blowing across the oceans like trade winds, and perhaps it would be better to just not look at the news.  But that does not help manage the perspective we need. The floodwaters are rising elsewhere. Ignoring it does not help.

I sat and listened to a beautiful but heart wrenching interview with a Dr in a small rural Hospital in Michigan USA on Friday – on Radio National.  He was quietly spoken and thoughtful.  There were some really curious points he made.  He described the situation where on that day he had no beds in his emergency dept, and no beds in the hospital – They were sending sick people on 2 hour ambulance journeys around the state to find a hospital with space to admit the  next patient.  And the paramedics were in that confined space with very sick people for the all the delays and the journey.

He noted that for the first 6 months of the pandemic they had been pretty quiet.  Rural towns have the space to be naturally spaced. And then it arrived, and he had been running from behind ever since.

He especially spoke of the difficulty of having the conversation with families on the inevitably when all interventions had failed and their loved one is dying.  However his county is a conservative heartland and, despite all the evidence, they absolutely believed a certain leader who told them that Covid19 was nothing, a mild flu, already beaten.  And they believed that narrative, despite all the news , all round the world, and from those of us spending our lives caring for their well being.   So even at the last breath they are still asking -why is the person dying when Covid 19 is not a problem it must be something else?

It speaks to the amazing capacity in the current ‘post truth world’ to bury one’s mind in a shimmering promise of hearing exactly what you want to hear, despite the evidence standing right up in front of you, grabbing your shirtfront, shouting and shaking you about.  But it has ever been thus.

So I looked up the demographics of Michigan – about 9.9Million people – not that different to NSW, some big cities and lots of rural. Some big industry – fairly familiar.

They have had about 590 000 cases of covid19.  Nearly 15000 people have died in that state, which is a mortality rare of about 2.5%, and 1 in 680 of their population, NSW still is only grieving 54 . Let’s keep looking after that.

Dr Rob in the Interview had his first vaccination about 3.5 weeks ago and was enthusiastically looking forward to his follow up booster.  So am I.

So, to the Vaccine

Much of the modern world operates on a “ hurry up and wait” process.  People often complain about this in health.  Man! I tell you it is excruciating – I have lived in that paradigm for decades.  But the nature of health is that it is truly a service and despite many economists attempts to call it a commodity, I will be happy to die having never believed that argument and will be proud that “service” still means something.  In fact, some philosophers might argue it is the only thing that  means something.

Still, not being so easily compartmentalised, then we still are doing so much of the “hurry up and wait”. With regard the vaccine rollout we have been very much trying to hurry up and get into it. But the reality is that there is still some time to wait.

It feels like that with the looming logistics of the vaccine rollout.  We are chafing at the bit to figure out how it will happen and I am being asked everyday when and what vaccines will be available, and how.

We have only this weekend been given the first official info about the vaccine availability from the federal govt.  There is a lot to work through.  You may not be surprised that, despite early excited reports about the vaccines being brought in earlier than expected…. There is not much action going to happen here till March.  Curiously, when I look back over the information our Pandemic Response Group put out at the start of the year, it pretty much matches up.  We have been trying to massage expectations all along with a bit of reality.

We must not drop the ball. We’ll still be near the middle of the year before we’re looking safer.

Regarding which ball, I have been asked about certain tennis balls.  Ok, I confess there are some issue that I just cannot explain.

So  – sorry, I am still not going to give any detail until I know for sure exactly how it will work.  It is so vital that we all understand each other, that there are no mixed messages, that the information we give to you is well researched, confident, unambiguous.  Like an Ikea assembly instruction!??

 

Watch this space.

 

Please feel free to discuss with your own GP who will also be a bit chaffed – which could explain any rash around the corners of the mouth.

 

Dr Trevor Cheney

 

 

 

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